Provider Demographics
NPI:1982022885
Name:GERMAN, VALERIE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:MARIE
Last Name:GERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3106
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-7711
Mailing Address - Country:US
Mailing Address - Phone:479-601-2314
Mailing Address - Fax:888-664-5545
Practice Address - Street 1:153 E MONTE PAINTER DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4002
Practice Address - Country:US
Practice Address - Phone:479-601-2314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-29
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036143724207R00000X
390200000X
ARE-11446207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program